This study is a retrospective review of prospectively collected data comparing perioperative and postoperative outcomes in patients undergoing robotic partial nephrectomy (RPN) or laparoscopic partial nephrectomy (LPN) for renal masses. Additionally, we evaluate the rates of achieving trifecta and "optimal outcome".

A total of 215 patients who underwent partial nephrectomy by a single surgeon between 2017 and 2025 were included (135 RPN, 80 LPN). Trifecta was defined as warm ischemia time (WIT) < 25 minutes, negative surgical margins, and no postoperative complications. "Optimal outcome" was defined as achieving the trifecta along with short-term (3-month) estimated glomerular filtration rate (eGFR) preservation > 90%. Postoperative complications were analysed using the Clavien-Dindo classification. Statistical analysis was performed using GraphPad Prism (version 10.4).

Of the 215 patients, 135 underwent RPN and 80 underwent LPN. The groups had comparable median age (61 vs. 58 years), tumor size (32 mm vs. 31 mm), and R.E.N.A.L. scores (8.0 vs. 8.0). WIT was 0 minutes in 46 RPN and 33 LPN cases, with no significant difference in median WIT (10 vs. 8 minutes, p = 0.6802). Negative surgical margin rates (93.60% vs. 86.11%, p = 0.1210), complication rates (5.93% vs. 6.25%, p = 0.5699), and eGFR preservation > 90% (77.59% vs. 77.63%, p = 0.9999) were comparable between groups. The rates of achieving trifecta (83.70% RPN vs. 77.50% LPN, p = 0.2800) and optimal outcome (70.37% RPN vs. 63.75% LPN, p = 0.3650) showed no significant difference between the groups.

There was no statistically significant difference in trifecta or optimal outcome rates between RPN and LPN. Both techniques demonstrated comparable perioperative and postoperative outcomes when performed by an experienced surgeon. These findings suggest that RPN and LPN are equally effective and safe options for partial nephrectomy.